| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,402 |
5,251 |
$376K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,710 |
2,639 |
$232K |
| V2020 |
Frames, purchases |
9,948 |
9,471 |
$190K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,518 |
5,033 |
$115K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,394 |
2,296 |
$66K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
899 |
799 |
$43K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
590 |
580 |
$28K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
360 |
357 |
$17K |
| 92015 |
Determination of refractive state |
1,535 |
1,532 |
$14K |
| 92002 |
|
123 |
123 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
163 |
162 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
71 |
67 |
$5K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
33 |
30 |
$575.64 |
| 3072F |
|
1,729 |
1,667 |
$0.00 |